Background: Cryptorchidism is a congenital disorder that causes an irregularity in the permanent or temporary descent of one or both testicles. In Brazil, there are no comprehensive studies describing the association of demographic, social, and clinical characteristics in relation to cryptorchidism.Objectives: This study aims to verify possible associations of clinical and sociodemographic characteristics in patients with cryptorchidism.Design and Methods: An analytical, descriptive and retrospective study was carried out based on secondary data of 5,168 live births with cryptorchidism recorded in the Live Birth Information System (SINASC), Brazil from 1999 to 2018. The socio-demographic factors analyzed were the geographic region, age, education and marital status of the mothers. The clinical factors analyzed were the duration and type of pregnancy. The place of birth was also analyzed as a secondary outcome.Results: This research analyzed all live births during the study period, in Brazil. The chance of cryptorchidism in the neonate is more common in women who become pregnant later (≥30 years of age) and with a higher level of education (≥8 years). The risk of cryptorchidism in relation to the federation units is higher in Paraíba, Pernambuco, Sergipe, São Paulo, and Santa Catarina. Regarding the clinical characteristics, the shorter pregnancies, which characterize premature births, are a risk for the appearance of cryptorchidism in the country.Conclusion: Thus, in this study, we found that sociodemographic and clinical factors have specific characteristics that predict cryptorchidism in newborns in Brazil.
Objetivo: Caracterizar os perfis social, clínico e hemodinâmico de pacientes admitidos em Unidade de Terapia Intensiva (UTI) que evoluíram a óbito e verificar a influência na sobrevida. Métodos: Coleta de prontuários de pacientes admitidos na UTI de um Hospital de referência terciária na região amazônica, que evoluíram a óbito (n=200), com análise das variáveis clínicas, sociais e hemodinâmicas e descrição das frequências absoluta e relativa, média, desvio padrão e intervalo de confiança de 95%. Resultados: Características sociais predominantes: idade 20-59 anos (48,5%), sexo masculino (52%), raça/cor pardo (72,5%), profissão empregada doméstica (10,5%), religião católica (6,5%), escolaridade 9 anos (21%) e estado civil solteiro (30%). Características clínicas principais: doenças respiratórias (20,5%), estado grave na admissão (70,5%), coma induzido (42%), acamados (87%), uso de ventilação mecânica invasiva (91%) e média de aspiração brônquica 1,27 ± 0,55 por dia. Complicações clínicas prevalentes: sepse (79,5%), choque (69%) e edema (61%). Uso de sonda vesical (82,5%) e tempo médio de internação 11,81 ± 9,50 dias. As características hemodinâmicas acentuadas foram: creatinina, uréia, lactato e leucócitos. Além disso, observou-se menor sobrevida de indivíduos da raça Branca e com leucocitose admissional. Conclusão: Este estudo auxilia na compreensão do perfil epidemiológico da população local, contribuindo no melhor manejo do paciente crítico. Descritores: Unidade de Terapia Intensiva, Perfil de saúde, Monitorização hemodinâmica, Sobrevida e Morte.
Based on reported cases of human rabies exposure to Colombia public health surveillance system between 2007 and 2016 we conducted a spatiotemporal analysis to identify epidemiological scenarios of human rabies exposure by dog, cat, bat or farm animal (n= 666,411 cases).Spatiotemporal analysis, incidence rate, cluster and outlier analysis were conducted for all Colombian cities (n= 1122). The incidence rate of human rabies exposure by dogs and cats showed an increasing trend while aggression by bats and farm animals fluctuated throughout the analyzed period. Human rabies transmitted by cat and bat occurred in Andean and Orinoquia region, where the larger scenario was observed. There, urban scenario showed high risk to human rabies exposure by cat and dog in cities characterized for having the highest human population density and greater economic development. In contrary, rural area where was observed high risk of human rabies exposure by farm animals in workers from agroforestry area (42.7%). exposed to rabies by contact of mucosa or injured skin with saliva infected with rabies virus (74.5%) composed rural scenario. In Inequality scenario, exposure by farm animals showed some outlier cities with high risk principally in Pacific region, where was observed the lowest incidence rates to human rabies exposure in all years studied and the highest poverty rates in Colombia. There, afro-descendant (55%) and indigenous (8.2%) people were mostly affected. High risk of exposure by bat bite was observed in indigenous (98.5%) located in cities of Amazon region with dispersed population (Amazonian scenario). Analysis presented here can encourage surveillance, care and prevention programs to focus both on ethnic, dispersed populations and areas with rabies viral circulation, since each scenario requires different approach strategies.
Objetivo: Analisar as variáveis sociais, clínicas e hemodinâmicas dos pacientes internados em Unidade de Terapia Intensiva (UTI) que evoluíram com sepse. Metodologia: Estudo retrospectivo, observacional e transversal. Foram elegíveis 224 prontuários, divididos em dois grupos: sepse presente (SP) n=165 e sepse ausente (SA) n=59. Foram descritas e analisadas as variáveis sociais, clínicas e hemodinâmicas. Resultados: As variáveis que tiveram associação com a sepse foram a baixa escolaridade e o estado civil casado. Nas variáveis clínicas observou-se que pacientes que precisam de intervenções invasivas foram associadas à sepse. As variáveis hemodinâmicas PaCO2, Be, Bicarbonato, leucócitos, hemácias, uréia, sódio e potássio alterados foram associados ao quadro de sepse. Estes pacientes permaneceram maior tempo na UTI e tiveram o óbito como desfecho. Conclusão: Existem variáveis sociais, clínicas e hemodinâmicas específicas que estão relacionadas à sepse. O conhecimento destas variáveis pode direcionar para que investimentos e recursos sejam direcionados visando prevenir esta complicação clínica.
Background Postoperative nausea and vomiting (PONV) is a distressing complication of anesthesia and can lead to aspiration, dehydration, and electrolyte imbalance. Antiemetic agents are conventionally prescribed to manage PONV; however, they have associated side effects. Therefore, unconventional methods, such as auricular acupuncture (AA), are also utilized to prevent and control emesis after surgery. AA originated in traditional Chinese medicine and is based on a diagnostic and treatment system that aims to normalize dysfunction through stimulation of reflex points on the ear. The aim of this study is to evaluate the effects of AA in controlling PONV. Methods We will perform a systematic review according to the Cochrane methodology. An overall search strategy will be developed and adapted for PubMed, PEDro, the Virtual Health Library, SciELO, EMBASE, the Web of Science, SciVerse Scopus, and the Cochrane Library to search for the following descriptors: “Acupressure”; “Antiemetics”; “Postoperative nausea and vomiting”; “Surgery”; “Auriculotherapy”; “Nausea”; “Vomiting”; and “Postoperative period.” Articles with a mean score of 6 ± 1.5 on the PEDro scale will be evaluated. The size of the intervention effect (Z) will be calculated for each outcome included in this review. The primary outcome will be the incidence of PONV. The secondary outcome will be the severity of PONV. Quality assessment will be performed with the Cochrane instrument. If possible, a meta-analysis will be performed using Review Manager 5.3 software. Discussion Several studies have reported positive outcomes of AA for patients with PONV. This study could provide robust and conclusive evidence of the usefulness of AA as an effective treatment alternative for emesis without the side effects of conventional medication. Trial registration Systematic review registration number: CRD42020149772 (S1 File)
Objectives: This study aimed to verify possible associations between sociodemographic and clinical factors in live births with spinal dysraphism .Methods: An analytical (descriptive and inferential), ecological study was carried out based on secondary data of 11,308 live births with spinal dysraphism registered in the Live Birth Information System (SINASC) in Brazil from 1999 to 2019. Demographic factors analyzed were age, education, mothers' marital status and geographic region. The clinical factors analyzed were duration, gestation period, birthweight and number of prenatal visits performed by women who underwent medical follow-up.Results: There was an increase in the number of cases of spinal dysraphism in recent years in Brazil with an annual percentage variation of 3.52%. However, the period from 2005 to 2009 showed a reduction in live births with spinal dysraphism . The regions with the highest incidence were the South and Southeast. The risk increased in mothers born after 1980, older than 30 years and with a high level of education. The risk was increased in live births of whites and blacks, born from double pregnancy and with body weight less than 3,000 g. The absence of prenatal care was associated with a higher incidence.Conclusion: Sociodemographic and clinical factors have speci c characteristics that can predict spinal dysraphism in newborns in Brazil.
Several factors may increase the risk of development of ovarian cancer. In this study, we investigated the relationship between social, genetic, and histopathologic factors in women with ovarian serous cystadenocarcinoma and titin (TTN) mutations, whether the TTN gene mutation may be a predictor, and its impact on mortality and survival in these patients. A total of 585 samples from patients with ovarian serous cystadenocarcinoma were collected from The Cancer Genome Atlas and PanCancer Atlas through the cBioPortal for analysis of social, genetic, and histopathological factors. Logistic regression was used to investigate whether TTN mutation could be a predictor, and the Kaplan–Meier method was applied to analyze survival time. TTN mutation frequency did not differ between age at diagnosis, tumor stage, and race, and was related to increased Buffa hypoxia score (p = 0.004), mutation count (p < 0.0001), Winter hypoxia Score (p = 0.030), nonsynonymous tumor mutation burden (TMB) (p < 0.0001), and reduced microsatellite instability sensor score (p = 0.010). The number of mutations (p < 0.0001) and winter hypoxia score (p = 0.008) were positively associated with TTN mutations, and nonsynonymous TMB (p < 0.0001) proved to be a predictor. Mutated TTN affects the score of genetic variables involved in cancer cell metabolism in ovarian cystadenocarcinoma.
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